Minimally Invasive Lumbar Spinal Fusion

Jason C. Eck, DO, MS

Dr. Eck received a Bachelor of Science degree from the Catholic University of America in Biomedical Engineering, followed by a Master of Science degree in Biomedical Engineering from Marquette University. Following this he worked as a research engineer conducting spine biomechanics research. He then attended medical school at University of Health Sciences. He is board eligible in orthopaedic surgery.

William C. Shiel Jr., MD, FACP, FACR

Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Minimally invasive lumbar spinal fusion facts

The majority of patients with low back problems improves within six to 12 weeks regardless of treatment and do not need surgery.

Minimally invasive lumbar spinal fusion attempts to achieve similar results to traditional techniques with less blood loss, less pain, less muscle damage and shorter hospital stay.

Minimally invasive lumbar spinal fusion through the abdomen has not been as effective and has increased risk of nerve damage compared to traditional fusion techniques.

Minimally invasive lumbar spinal fusion through the back has been shown to be as effective as traditional techniques with less blood loss, less pain and shorter hospital stays.

Introduction to lumbar spinal fusion

The lumbar spine is the lower portion of the spine found at the center of the curve of the low back,
below the rib cage. This area can be a common source of pain. Low back pain is the second most common reason for visits to the family physician, behind the common cold. As people become older, various changes occur in the lumbar spine that can cause pain. In most cases these changes are
due to normal degenerative arthritis (wear of cartilage over time). The physician must also rule out other more serious conditions including tumor, infection,
scoliosis (curvature of the spine), spondylolisthesis (slippage of one spinal
bone on another), or fracture.

Fortunately, most patients with low back pain will have improvement in their symptoms regardless of treatment within six weeks. During that time the physician has various treatment options including medications, physical therapy, or injections that can help ease the symptoms. Some of those patients that do not improve
after six to 12 weeks may be candidates for surgery. The spine surgeon has different types of surgical options available based on the specific cause of pain.

What is lumbar spinal fusion?

Lumbar spinal fusion is an operation that causes the vertebrae (bones of the spine) in the lower back to grow together. The goal of the lumbar fusion is to have the two vertebrae fuse (grow solidly together) so that there is no longer any motion between them. Removing the intervertebral disc
(cushion between the bones) or bone spurs can reduce some of the pressure on the nerves, helping to reduce pain. Additionally, by fusing the two vertebrae together,
this may stop the formation of bone spurs at that location, further reducing pain and potential nerve injury.

There are many different specific techniques to try to fuse the vertebrae together. The surgery can be performed either through an incision in the back, the abdomen, or a combination of both. In many cases metal screws and rods are placed from the back into the bones to hold them
in position while the fusion occurs. During an interbody fusion, the surgeon removes the intervertebral disc and places either a
bone graft or a metal or plastic cage, or a combination of these in its place. The decision on what type of fusion is best for each patient is based on their specific complaints and the cause of symptoms. Spinal fusion can be very effective in the properly selected patient.